Distress and inflammation are independently associated with cancer-related symptom severity

Objective

To evaluate longitudinal associations of distress and inflammation with somatic and depressive symptom severity in breast cancer patients, from before to six months after neoadjuvant chemotherapy. We also explored feasibility and effects of an early mindfulness-based intervention for preventing or reducing somatic and depressive symptoms.

Methods

Longitudinal pilot study with a randomized waitlist-controlled intervention design. Women with breast cancer were randomized to receive access to a smartphone application offering meditation exercises, either immediately after baseline testing (intervention group) or after study completion (control group) in a 1:1 ratio. Assessments (self-report questionnaires and a blood draw when feasible) were completed before, halfway through, immediately after, and 6 months after completing neoadjuvant chemotherapy.

Results

Fifty evaluable women were enrolled. Somatic symptom severity increased during chemotherapy, whereas depressive symptom severity was at its peak before treatment and declined gradually thereafter. Distress was positively associated with depressive symptom severity. Only Distress Thermometer-results were positively associated with somatic symptom severity. Inflammation was positively associated with both types of symptoms, and distress did not moderate the associations between inflammation and symptom severity. Intervention adherence was low and no intervention effect on symptom experience was observed.

Conclusion

Inflammation and distress are independently associated with somatic and depressive symptoms experienced during breast cancer treatment.